PMID- 36719017
OWN - NLM
STAT- MEDLINE
DCOM- 20230201
LR  - 20230215
IS  - 1976-2437 (Electronic)
IS  - 0513-5796 (Print)
IS  - 0513-5796 (Linking)
VI  - 64
IP  - 2
DP  - 2023 Feb
TI  - Clinical Outcomes of Endoscope-Assisted Pulmonary Endarterectomy for Chronic 
      Thromboembolic Pulmonary Hypertension.
PG  - 104-110
LID - 10.3349/ymj.2022.0437 [doi]
AB  - PURPOSE: Pulmonary thromboembolism is a potentially life-threatening condition in 
      patients with heart disease; however, limited studies discussing long-term 
      outcomes exist. This study aimed to investigate the long-term outcomes of 
      pulmonary endarterectomy (PEA) in patients with chronic thromboembolic pulmonary 
      hypertension (CTEPH), focusing on the improvement of functional class and right 
      ventricular (RV) pressure. MATERIALS AND METHODS: Clinical data of patients with 
      CTEPH were obtained from Yonsei Hospital between May 2012 and December 2021, and 
      reviewed retrospectively. Twenty-six patients underwent endoscope-guided PEA 
      during the study period, and the mean follow-up duration was 24.8+/-23.4 months. 
      RESULTS: After PEA, most patients (88.5%) were weaned from inotropes without 
      extracorporeal membrane oxygenation support during the first few days. Two 
      patients (7.6%) had cerebrovascular accidents without neurological deficits. On 
      echocardiography, the RV systolic pressure and tricuspid regurgitation grades 
      significantly improved (p<0.001). Furthermore, the mean left ventricle 
      end-diastolic diameter was significant increased (p=0.003), and the left 
      ventricular end-systolic diameter increased (p<0.001). The median intensive care 
      unit stay was 3.0+/-9.4 days, and median hospital stay 16.0+/-26.5 days. The 5-year 
      survival rate was 95.5%, and the 5-year freedom rate of cardiac death was 100%. 
      There was a marked improvement in New York Heart Association (NYHA) status 
      (p<0.001). Cox regression suggested that the main pulmonary artery (MPA) 
      involvement is a significant predictor of non-improvement in functional class 
      post-PEA. CONCLUSION: Mortality rates are low and patients experience a marked 
      improvement in NYHA class and health status after PEA. Moreover, MPA involvement 
      may affect functional outcomes.
CI  - (c) Copyright: Yonsei University College of Medicine 2023.
FAU - Kim, Hyo-Hyun
AU  - Kim HH
AUID- ORCID: 0000-0002-1608-9674
AD  - Division of Cardiovascular Surgery, Severance Cardiovascular Hospital, Yonsei 
      University College of Medicine, Yonsei University Health System, Seoul, Korea.
FAU - Lee, Hyun-Soo
AU  - Lee HS
AUID- ORCID: 0000-0003-3684-6510
AD  - Division of Cardiovascular Surgery, Severance Cardiovascular Hospital, Yonsei 
      University College of Medicine, Yonsei University Health System, Seoul, Korea.
FAU - Kim, Hyun-Sik
AU  - Kim HS
AUID- ORCID: 0000-0001-7542-8122
AD  - Division of Cardiovascular Surgery, Severance Cardiovascular Hospital, Yonsei 
      University College of Medicine, Yonsei University Health System, Seoul, Korea.
FAU - Youn, Young-Nam
AU  - Youn YN
AUID- ORCID: 0000-0002-7755-1877
AD  - Division of Cardiovascular Surgery, Severance Cardiovascular Hospital, Yonsei 
      University College of Medicine, Yonsei University Health System, Seoul, Korea. 
      ynyoun@yuhs.ac.
LA  - eng
PT  - Journal Article
PL  - Korea (South)
TA  - Yonsei Med J
JT  - Yonsei medical journal
JID - 0414003
SB  - IM
MH  - Humans
MH  - *Hypertension, Pulmonary/surgery/etiology
MH  - Retrospective Studies
MH  - Treatment Outcome
MH  - *Pulmonary Embolism/surgery
MH  - Pulmonary Artery/surgery
MH  - Endarterectomy/adverse effects
MH  - Chronic Disease
PMC - PMC9892545
OTO - NOTNLM
OT  - Pulmonary arterial hypertension
OT  - endarterectomy
OT  - functional status
COIS- The authors have no potential conflicts of interest to disclose.
EDAT- 2023/02/01 06:00
MHDA- 2023/02/02 06:00
PMCR- 2023/02/01
CRDT- 2023/01/31 07:12
PHST- 2022/09/30 00:00 [received]
PHST- 2022/11/30 00:00 [revised]
PHST- 2023/01/02 00:00 [accepted]
PHST- 2023/01/31 07:12 [entrez]
PHST- 2023/02/01 06:00 [pubmed]
PHST- 2023/02/02 06:00 [medline]
PHST- 2023/02/01 00:00 [pmc-release]
AID - 64.104 [pii]
AID - 10.3349/ymj.2022.0437 [doi]
PST - ppublish
SO  - Yonsei Med J. 2023 Feb;64(2):104-110. doi: 10.3349/ymj.2022.0437.